Hostname: page-component-cb9f654ff-mx8w7 Total loading time: 0 Render date: 2025-08-29T13:30:22.610Z Has data issue: false hasContentIssue false
  • English
  • Français

Retrograde sharp potential resembling the his-bundle electrogram: is this a case of atrioventricular re-entrant tachycardia involving twin atrioventricular nodes with the anterior node exhibiting only retrograde conduction?

Published online by Cambridge University Press:  09 September 2020

Gaku Izumi Open the ORCID record for Gaku Izumi [Opens in a new window] ,
Hisashi Yokoshiki  and
Atsuhito Takeda
Gaku Izumi*
Affiliation:
Department of Paediatrics, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
Hisashi Yokoshiki
Affiliation:
Department of Cardiovascular Medicine, Sapporo City General Hospital, Chuo-ku, Sapporo 060-8604, Japan
Atsuhito Takeda
Affiliation:
Department of Paediatrics, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
*
Author for correspondence: Gaku Izumi, MD, PhD, Department of Paediatrics, Hokkaido University Graduate School of Medicine, North-15 West-7, Sapporo 060-8638, Japan. Tel: +81 11 706 5954; Fax: +81 11 706 7982. E-mail: gaku-izumi0920@med.hokudai.ac.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

A 2-year-old male with right isomerism was referred for supraventricular tachycardias. Atrial pacing study revealed that anterograde conduction was only through the posterior atrioventricular node. During the mapping of ventriculoatrial conduction, we identified a sharp potential resembling a His-bundle electrogram with a decremental property at the anterior wall of the common atrium. Catheter ablation for the potential eliminated the anterior ventriculoatrial conduction, thereby indicating retrograde activation of the possible anterior atrioventricular node.

Keywords

Atrioventricular re-entrant tachycardiatwin atrioventricular nodesright atrial isomerism

Information

Type
Brief Report
Information
Cardiology in the Young , Volume 30 , Issue 12 , December 2020 , pp. 1940 - 1942
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Wenink, AC. Congenitally complete heart block with an interrupted Mönckeberg sling. Eur J Cardiol 1979; 9: 89–99.Google ScholarPubMed
Mori, H, Sumitomo, H, Muraji, S, Imamura, T, Kobayashi, T, Kato, R. Successful demonstration of the detailed connection between the twin atrioventricular nodes and sling in a patient with asplenia syndrome. HeartRhythm Case Rep. 2018; 4: 480–483.CrossRefGoogle Scholar
Bessiere, F, Mongeon, FP, Therrien, J, Khairy, P. Magnetic-guided catheter ablation of twin AV nodal reentrant tachycardia in a patient with left atrial isomerism, interrupted inferior vena cava, and Kawashima-Fontan procedure. Clin Case Rep. 2017; 5: 2105–2110.CrossRefGoogle Scholar
Bae, EJ, Noh, CI, Choi, JY, et al. Twin AV node and induced supraventricular tachycardia in Fontan palliation patients. Pacing Clin Electrophysiol. 2005; 28: 126–134.CrossRefGoogle ScholarPubMed
Takeuchi, D, Shoda, M, Takahashi, K, Nakanishi, T. Absence of a resetting phenomenon suggests that a sling works as a part of the supraventricular tachycardia circuit involving twin atrioventricular nodes: a case of corrected transposition of the great arteries. HeartRhythm Case Rep. 2015; 1: 220–224.CrossRefGoogle ScholarPubMed